HomeMy WebLinkAboutBLD15010 Final Mobile Home - BLD Permit / Conditions - 2/9/1984 BUSHFIELD, Carla #15010
12-13-83
Beards Cove, Division 3, Lot 30
Turn Right on Sandhill Road, left on 1st dirt road,
first Street Right, lot on left next to grey Double-wide
Contractor
Harobr Mobile - Gorst
Mobile Home
$16,576.00
Shorelines:
Setback:
Special Conditions:
Footing:
Setback:
Foundation Walls:
Framing:
Fireplace:
Wood Stove:
Plumbing:
Mechanical:
Roof:
Exterior :
Interior:
Final:
Stop Work:
Mobile Home:
Smoke Detector:
Remarks:
BUILDING PERMIT APPLICATION
MASON COUNTY
P.O. Box 186 Shelton, Washington 98584
426-5593 I S?
DATE ISSUED
PERMIT NO. I GO 10
OWNER N ME MAI ADDRE�OX CITY&STATE ZIP PHONE
1v WA F
DIRECTIONS LD'T (9� LI:F
TO JOB SITE �yA R( 0 �� fR RS S - Ofue +0 QR
LEGAL. `- 'C��1 ( JV C l'O 1 SEE ATTACHED HEETI LJOk !Q
DESCR
NAME MAIL A D`/REESSS CI &STATE LICENSE NO. PHONE
CONTRACTOR v �-�o r I`r ( I l -e
USE OF
BUILDING HOME
Class of work: NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR 19 MOVE ❑ REMOVE
Describe work:
OrJ PROPERTIL4
46q�q Ig so
Valuation of work: $ �76 Q PLAN CHECK FEE PERMIT FEE . .
SPECIAL CONDITIONS:
BEDROOMS I DECKS CARPORT i , NOTICE
BATHROOMS ITOTAL SO. FT. GARAGE :
ATTACHED i SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, HEATING, VENTILATING
NO. OF STORIES BASEMENT I 1 OR AIR CONDITIONING.
TOTAL SQ. FT. FIREPLACE I j DETACHED I_;
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR-
CONTRACTOR AFFIDAVIT IZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FORA PERIOD OF 180 DAYS AT ANYTIME AFTER
I certify that I am a currently registered contractor in WORK IS COMMENCED.
the State of Washington and I the
aware of the FOR F F I C E USE ONLY
ordinance requirements regulating the work for which
the permit is issued and all work done will be in
conformance therewith. PERMANENT iNZ SHORELINES
SEASONAL I FLOODPLAIN [
Firm
E.D. NO. S.E.P.A. Li
By Special Approvals IN OUT YES APPROVED NO
Lic. No. Date ZONING
PLANNING DEPT.
OWNERS AFFIDAVIT HEALTH DEPT.
PUBLIC WORKS
I certify that I am exempt from the requirements of the FIRE MARSHAL
contract or registration law RCW 18.27, and am aware
o the Mason County ordinance requirements for BUILDING DEPT.
hich this permit is issued and that all work done will ROAD ACCESS
be in conformance therewith. MOTOR VEHICLE PERMIT
Q,, PLANS CHECK BY APPROVED FOR ISSUANCE
O er L %=�
Date . BY
1 PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
PLOT PLAN
ADDRESS J PERMIT NO. F
0
z
A D
D O
O
LEGAL a
DESCRIPTION LOT BILK ADDITION u
SITE AREA Sq. Ft. AREA OF SITE OCCUPIED BY BUILDINGS Sq. Ft.
INSTRUCTIONS TO APPLICANT
THIS FORM NEED NOT BE USED WHEN PLOT PLANS DRAWN TO SCALE OF NOT LESS THAN 1"=20' ARE
FILED WITH PERMIT APPLICATION. (EACH BUILDING SITE MUST HAVE A SEPARATE PLOT PLAN.)
FOR NEW BUILDINGS PROVIDE THE FOLLOWING INFORMATION IN THE SPACE BELOW: LOCATION OF
PROPOSED CONSTRUCTION AND EXISTING IMPROVEMENTS.SHOW BUILDING,SITE,AND SETBACK DIMEN-
SIONS. SHOW EASEMENTS, FINISH CONTOURS OR DRAINAGE, FIRST FLOOR ELEVATION, STREET ELEVA-
TION ARID SEWER SERVICE ELEVATION. SHOW LOCATION OF WATER, SEWER, GAS AND ELECTRICAL
SERVICE LINES.SHOW LOCATION OF SURVEY PINS.SPECIFY THE USE OF EACH BUILDING AND MAJOR POR-
TION THEREOF.
/r INDICATE NORTH IN CIRCLE GRAPH SQUARES ARE 5' X 5' OR 1"=20'
1
1`
� w
4 .
I/We certify that the proposed construction will conform to the dimensions and uses shown above and that no changes will be made without
first obtaining approval.
NAME(S) OF OWNER(S) OF SITE d STRUCTURE(S) (PRINT) SIGNATURE OF OWNER(S) OR AUTHORIZED REPRESENTATIVE
DO NOT WRITE BELOW THIS LINE
APPROVED _
DISTRICT AS NOTED DATE
6HELTON PRINTING